EARLY REPAIR OF COMPLEX ORBITAL FRACTURES

被引:3
作者
DENNY, AD
GONNERING, RS
机构
[1] Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee
[2] Department of Opthalmology, Medical College of Wisconsin, Milwaukee
来源
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES | 1990年 / 10卷
关键词
Dystopia; Enopthalmus; Exposure; Intraorbital volume; Three-dimensional CT scan;
D O I
10.1097/00006982-199010001-00004
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Complex orbital fractures consist of fractures of the orbital rim and walls in two or more places and may be associated with more extensive facial fractures. Previously, delayed repair was the standard approach. Techniques of craniofacial surgery allow earlier reconstruction with more accuracy and stability. Enophthalmus, dystopia and facial contour deformities are avoided, and the final result improved. A new standard has been established. Three factors are important in attaining improved results. Three-dimensional CT scanning is used to obtain a comprehensive as sessment of the injury, to plan reconstruction pre-operatively, and to assess the reconstruction post-operatively. Secondly, complete exposure of the facial skeleton is necessary and is achieved by the use of a coronal incision, frontal flap, infraorbital incision, and intraoral upper sulcus incision. Thirdly, cranial bone grafting is used to reconstruct orbital floors and severely comminuted or missing bones. Finally, the use of mini-plates and lag screws provides improved accuracy and stability of the reconstruction. © The Ophthalmic Communications Society, Inc.
引用
收藏
页码:S8 / S19
页数:12
相关论文
共 29 条
[1]  
Pfeiffer R.L., Traumatic enophthalmus, Arch Ophthalmol, 30, (1943)
[2]  
Jackson I.T., Management of Acute Craniofacial Injuries, 441 Craniofacial Surgery
[3]  
Manson P., Et al., Midface Fractures: Advantages of Immediate Extended Open Reduction and Bone Grafting, Plast Reconstr Surg, 76, (1985)
[4]  
Gruss J.S., Et al., The Role of Primary Bone Grafting in Complex Craniomaxillofacial Trauma, Plast Reconstr Surg, 75, (1985)
[5]  
Tessier P., Total Osteotomy of the Middle Third of the Face for Facio-stenosis or for Sequelae of LeFort III Fracture, Plast Reconstr Surg, 48, (1971)
[6]  
Tessier P., Et al., Chirurgie Plastique Orbito-Palpeʼbrale, (1977)
[7]  
Tessier P., Hervouet F., Delbet J.P., Dislocations Orbito-Nasals, Plastic and Reconstructive Surgery of Eye and Adnexa, pp. 96-100, (1962)
[8]  
Jackson I.T., Hide T.A.H., Further Extensions of Craniofacial Surgery, Recent Advances in Plastic Surgery (2nd ed.), (1981)
[9]  
Shaw R.C., Parsons R.W., Exposure Through a Coronal Incision for Initial Treatment of Facial Injuries, Plast Reconstr Surg, 56, (1974)
[10]  
Jones W.D., Whitaker L.A., Murtaugh F., Applications of Reconstructive Craniofacial Techniques to Acute Upper Facial Trauma, J Trauma, 17, (1977)